Reports Of Committees
| Published date | 01 November 1974 |
| DOI | http://doi.org/10.1111/j.1468-2230.1974.tb02410.x |
| Date | 01 November 1974 |
REPORTS
OF
COMMITTEES
THE LANE
COMMITTEE
REPORT
ON
THE
ABORTION
ACT
THE Lane Committee’s brief was to inquire into the working of the
Abortion Law Reform Act
1967
in the light of criticisms against
it,
without reviewing its underlying principles. The chief complaints
were that there was abortion on demand for those who could afford
it
in the private sector, whilst for those who could not,
it
was becom-
ing increasingly difficult to obtain one
on
the National Health
Service, opportunities varying from area to area depending on the
attitudes of consultants.
It
was contended that doctors with objec-
tions to the Act who applied for gynaecological posts were being
discriminated against, that recruitment was falling
off
,
that the
doctor-patient relationship was being ruined by
‘(
the hectoring
attitudes of abortion patients
)’
demanding their rights, and that
the influx of foreign women and the profiteering of the private sec-
tor had reached scandalous proportions.
After three years of deliberation, the Lane Committee has pro-
duced a three-volume report which deals with every facet of the
problem. Its quality is uneven. On occasions the level of argument
and the assumptions upon which
it
is based, descend
to
reflect the
underlying ideology and homely wisdom found in women’s maga-
zines. However
it
does provide a lucid and impartial exposition of
the issues involved as well as statistical data and information which
help place the controversial issues
in
perspective. To those who
believed that the Act forced N.H.S. gynaecology departments to
divert much of their resources into providing abortions, the Report
points out that abortion has always formed a substantial part of
their workload. In
1959,
for example,
it
accounted for about one
fifth
of
all cases
(56,900),
most of which
(55,100)
were non-thera-
peutic,
i.e.
begun illegally
or
resulting from a miscarriage. As legal
abortion becomes more readily obtainable, non-therapeutic abor-
tions will constitute a diminishing proportion of the total number
of abortions in the N.H.S. This has already begun to happen, with
the number of non-therapeutic abortions in
1971
at
their lowest level
since
1960.
The fact remains, however, that in
1972
twice as many
abortions were performed in the private sector as on the N.H.S.
and that whilst in
1971
in Newcastle a record
80
per cent. of termi-
nations were performed under the N.H.S., the same could be said of
only
20
per cent.40 per cent. of those performed in the Birming-
ham area, Further statistics indicate that there are more than
merely numerical differences between private and public sector
1
Report
of
the Committee
on
the Working
of
the Abortion Act, Cmnd.
G579,
1974.
3
Para.
31.
657
658
THE
MODERN
LAW REVIEW
VOL.
37
abortions. In
1971
nearly half of all married women,
266
per cent.
of the total who were aborted on the
N.H.S.,
were sterilised at the
same time as compared with
0.7
per cent. of the total in the private
sector, Moreover,
N.H.S.
patients tend to have their abortions at
a
later gestation period than private ones, after thirteen weeks in
27-5
per cent, cases in
1971.
These two factors combine to explain
the high mortality rates here as compared with Eastern European
countries. The risk of death is highest where abortion is performed
after thirteen weeks by abdominal hysterotomy.
11,862
such opera-
tions were performed in England and Wales
in
1969-71.
The risks
are further increased where the operation is followed by sterilisation.
Even where sterilisation accompanies vaginal terminations, which
are far safer than abdominal ones, after a gestation period of less
than thirteen weeks, the fatality risk increases tenfold. The Com-
mittee asserts that in Eastern Europe the vast majority
of
termina-
tions are performed by the twelfth week by vaginal methods and
are scarcely ever accompanied by sterilisation.
It
strongly recom-
mends that
a
similar practice should be followed here.
However, the desirability of destroying the embryo at an early
stage has not persuaded the Committee
to
favour widespread use
of a new method known as menstrual aspiration (M.A.). This is
so
simple to apply that certain women’s groups wish to run their own
clinics for the purpose. The Committee is surely right to insist that
medically unqualified persons should not be permitted to use
M.A.
because of the risk of perforation, infection
or
damage, particularly
where
it
is
carried out repeatedly. But where
it
is performed by a
doctor, M.A. would appear to have all the advantages of speed (no
anaesthetic is required), safety and comparative painlessness. The
Committee recommends however that the Abortion Act be amended
specifically to include it despite the fact that
it
is typically used on
women with less than two weeks amenorrhoea, at which stage there
is no way of knowing whether a woman is in fact pregnant. The
consent of two doctors would be necessary as usual. The effect of
this would be to limit severely the use of M.A. on the
N.H.S.
for
although it can be used on women with no more than six weeks
amenorrhoea, given the present structure and functioning
of
the
system,
it
tends to take several months before the procedures
demanded by the Act are completed. Moreover, whilst the Com-
mittee specifically approves the setting
up
of day-care facilities for
the use of vacuum aspiration (V.A.),
it
is clearly not the Commit-
tee’s intention that these should provide
M.A.
as well. Both
methods, however, operate on similar lines. Both involve extract-
ing the contents of the womb by means of suction. In the case
of
V.A., which can be performed up until the twelfth week, a pump is
used, but with
M.A.,
which is performed much earlier, only
a syringe is necessary. M.A. is no more than a simplified version
of V.A., a tea-time as against a lunch-time abortion.
The underlying reason for the Committee’s recommendation
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